ArticlePloS one2020
Medical findings and symptoms in infants exposed to witnessed or admitted abusive shaking: A nationwide registry study.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It carries an expression of concern. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 33 citations in OpenAlex.
- Spread of "triad diagnostics" in suspected Shaken Baby Syndrome.Forensic science international. Synergy · 2026Article
- Pathophysiological hypotheses of the triad in abusive infant shaking: A systematic review and analysis of corroborated cases.Forensic science international. Synergy · 2025Article
- A critical review of the American Academy of Pediatrics technical report on abusive head trauma.Forensic science international. Synergy · 2025Review
- Response to Comment on 26 cm Fall Caught on Video Causing Subdural Hemorrhages and Extensive Retinal Hemorrhages in an 8-Month-Old Infant.Clinical case reports · 2025Article
- Commentary on Witnessing Abusive Head Trauma: Accidents Show Higher Rates of Intracranial Pathologies Than Shaking-Caution Is Warranted.Annals of the Child Neurology Society · 2025Article
- A Systematic Review of Pediatric Abusive Head Trauma: What a Surgeon Needs to Know Before Using a Knife.Cureus · 2025Review
- Identifying Abusive Head Trauma in an Infant.Cureus · 2024Article
- Witnessing abusive head trauma: Accidents show higher rates of intracranial pathologies than shaking.Annals of the Child Neurology Society · 2024Article
- An Update to Biomechanical and Biochemical Principles of Retinal Injury in Child Abuse.Children (Basel, Switzerland) · 2024Review
- Article
- Evidence for significant misdiagnosis of abusive head trauma in pediBIRN data.Forensic science international. Synergy · 2023Article
- Why admitted cases of AHT make a low quality reference standard: A survey of people accused of AHT in France.Forensic science international. Synergy · 2023Article
- Agreements and disagreements regarding "shaken baby syndrome".Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2022Article
- Is external hydrocephalus a possible differential diagnosis when child abuse is suspected?Acta neurochirurgica · 2022Article
- Transfer of knowledge to diagnose infant abuse and its incidence - a time-series analysis from Sweden.Implementation science : IS · 2022Article
- The legal challenges to the diagnosis of shaken baby syndrome or how to counter 12 common fake news.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2022Review
Corrections and comments
- Expression of concern
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany physicians regard the combination of encephalopathy, subdural haemorrhage (SDH), retinal haemorrhage (RH), rib fractures, and classical metaphyseal lesions (CML) as highly specific for abusive head trauma (AHT). However, without observed abuse or other criteria that are independent of these findings, bias risk is high.
methodsInfants subjected for examination under the suspicion of maltreatment during the period 1997-2014 were identified in the National Patient Registry, International Classification of Diseases (ICD-10 SE). The medical records were scrutinized for identification of cases of witnessed or admitted physical abuse by shaking. The main outcome measures were occurrence of SDH, RH, fractures and skin lesions.
resultsAll identified 36 infants had been shaken, and for 6, there was information indicating blunt force impact immediately after shaking. In 30 cases, there were no findings of SDH or RH, rib fractures, or CMLs. Six infants had finding(s) suggestive of physical abuse, two with possible acute intracranial pathology. One infant with combined shaking and impact trauma had hyperdense SDH, hyperdense subarachnoid haemorrhage, suspected cortical vein thrombosis, RH, and bruises. Another infant abused by shaking had solely an acute subarachnoid haemorrhage. Both had pre-existing vulnerability. The first was born preterm and had non-specific frontal subcortical changes. The other had bilateral chronic SDH/hygroma.
conclusionsThe present findings do not support the hypothesis that acute SDH or RH can be caused by isolated shaking of a healthy infant. However, they do suggest that abuse by shaking may cause acute intracranial haemorrhage with RH in infants with certain risk factors.
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